Flow-through arterialized venous free thenar flaps for palmar soft tissue defects in fingers

ObjectiveTo evaluate the efficacy of venous free thenar flaps for reconstructing palmar soft tissue defects in fingers.MethodsFrom December 2018 to October 2019, 11 patients with palmar soft tissue defects in fingers were treated using venous free thenar flaps. At the final follow-up, the range of thumb radial and palmar abduction on the injured side and opposite side was calculated. The total active movement (TAM) of the injured and opposite fingers and flap sensibility recovery were also recorded.ResultsThe mean follow-up time was 13.4 months, all flaps survived, and all wounds at the donor sites healed with no skin necrosis. At the last follow-up, the average range of thumb radial abduction and thumb palmar abduction on the injured side was 96.6% and 95.9% of the value on the opposite side, respectively. The average TAM of the injured fingers was 98.2% of the value of the opposite fingers. Sensation in the flaps was restored to grade S2 to S3.ConclusionVenous free thenar flaps can be alternatives for reconstructing palmar soft tissue defects in fingers.     

A Study of Dermatoglyphic Patterns in Epileptic Patients

The aim of study was to establish a relation of dermatoglyphic patterns of palm in epileptic and normal subjects so that it may be used as a diagnostic tool for identifying cases at risk. The dermatoglyphic study was carried out on 50 patients of epilepsy and 50 normal subjects. The dermatoglyphic traits, which presented a significant difference, were a-b ridge count, lateral deviation, c-line pattern, palmar pattern and finger tip pattern. Mean values of a-b ridge count were more in epileptic patients, especially in left hand, than controls. The ratio of ulnar and radial lateral deviation in control was 1:3 while in epileptic it was 1:5. C-line pattern presented less frequency of proximal and ulnar type patterns in cases. Radial type of C-line pattern was higher in cases. On the other hand this pattern was absent in 29% of controls than cases (8%). Arch type of palmar patterns were showing a very significant difference between controls (79%) and cases (2%). Frequency of loops were much more and vestiges were absolutely absent in cases. The frequency of Arch type of finger tip pattern was more in control. These findings suggest that antenatal factors may contribute to the etiology of epilepsy. A considerable progress in dermatoglyphics has been established as a useful diagnostic and research tool in medicine.     

不同吻合方式修复双侧指固有神经缺损疗效比较

目的比较不同神经吻合方式修复双侧指固有神经缺损的临床疗效。方法选择70例双侧指固有神经缺损患者按照不同神经吻合方式分成A、B、C 3组:A组24例采用移植神经弓端侧吻合,B组26例采用移植神经弓双端侧吻合,C组20例采用移植神经直接桥接端端吻合。观察3组指关节自主活动度总和(TAM)、感觉恢复情况、两点辨别觉和不良反应发生情况。结果患者均获得随访,时间1~10个月。3组指关节TAM优良率比较差异无统计学意义(P0.05)。A组和B组远节指腹感觉明显高于C组(P0.05),A、B两组比较差异无统计学意义(P0.05)。A组和B组两点辨别觉明显低于C组(P0.05),A、B两组比较差异无统计学意义(P0.05)。3组患者伤口均甲级愈合,未出现伤口感染和皮肤软组织坏死。术后72 h出现血管危象A组1例、B组2例、C组1例,均在肌肉注射盐酸哌替啶+静脉滴注肝素钠后缓解。B组2例术后4~6周用力握物时出现麻木和放射性疼痛等,术后6~12周疼痛自行消失。结论移植神经弓端侧吻合能够有效修复双侧指固有神经缺损,促进指腹感觉的恢复,效果优于移植神经直接桥接端端吻合。     

A critical overview of the current myofascial pain literature – January 2018

The majority of papers included in the quarterly review discuss various aspects of dry needling (DN), which continues to be of interest to researchers and clinicians. A study by Liu et al. is the first paper to examine the effects of DN of acetylcholine, esterase and receptors. The study provides support for the integrated trigger point hypothesis and for DN. A paper by Hightower and colleagues found an intriguing link between low magnesium levels in the drink water supply, vitamin D, and myofascial pain, cancer, tendon ruptures, and colon polyps. Contributions originated in the Brazil, China, Germany, Iran, India, Poland, South Korea, Spain, Taiwan, Turkey, and the US.     

Different hypersensitivities against homologous proteins of MGL_1304 in patients with atopic dermatitis

Background

Atopic dermatitis (AD) is exacerbated by sweating, and the skin of most patients with AD are resided by Malassezia (M.) fungi. Recently, MGL_1304 produced by Malassezia globosa was identified as the major histamine releasing antigen in human sweat.

Impact of Triggering Events on Outcomes of Acute Heart Failure

Background

The onset of acute heart failure is known to be associated with increased physical activity and other specific behaviors that can trigger hemodynamic deterioration. This analysis aimed to describe the distribution of triggers in patients hospitalized for acute heart failure, and investigate their effects on in-hospital outcomes.

术后镇痛对断指再植成活的影响

目的 探讨断指再植术后镇痛效果对于患者断指再植成功率的影响。方法 按照患者意愿分为术后患者自控静脉镇痛组和常规对照组。比较两组在镇痛效果、血管危象发生情况、断指再植成活率以及患者血管内皮生长因子(VEGF)表达情况。结果 术后患者自控静脉镇痛组术后0~12 h、12~24 h以及24~72 h疼痛视觉模拟评分分别为(4.3±2.3)、(3.6±1.9)、(2.4±1.7)分,镇痛效果优于常规对照组(P<0.05)。患者自控静脉镇痛组血管危象发生率低于常规对照组(P<0.05)。患者自控静脉镇痛组在术后18~24 h、66~72 h、114~120 h VEGF分别为(56.43±19.64)、(98.40±25.46)、(68.67±18.94)pg/mL,各时间点均高于常规对照组。患者自控静脉镇痛组断指再植成活率94%高于常规对照组76%,差异有统计学意义。结论 断指再植术后镇痛效果影响断指再植成功率。     

Ac-SDKP经HSP27调节锌指蛋白而抑制肺上皮细胞-间质转化

目的:探讨N-乙酰基-丝氨酰-天门冬酰-赖氨酰-脯氨酸(Ac-SDKP)是否通过抑制热休克蛋白27(heat-shock protein 27,HSP 27)的表达,进而抑制锌指蛋白SNAI1、SNAI2的表达,而发挥阻抑转化生长因子(TGF)-β1诱导的人肺泡Ⅱ型上皮细胞向间质细胞(肌成纤维细胞)的转化以及Ⅰ型、Ⅲ型胶原蛋白的表达。方法:激光共聚焦检测TGF-β1诱导的人肺泡Ⅱ型上皮细胞向肌成纤维细胞转化中HSP27及SNAI1、SNAI2蛋白的共定位表达;real-time PCR法检测HSP27、SNAI1和SNAI2 mRNA的表达;Western blotting法检测HSP27、SNAI1、SNAI2和Ⅰ型、Ⅲ型胶原蛋白的表达,以及转染HSP27干扰质粒后SNAI1、SNAI2蛋白及Ⅰ型、Ⅲ型胶原蛋白表达的变化。结果:与对照组相比,TGF-β1刺激组HSP27、SNAI1、SNAI2及Ⅰ型、Ⅲ型胶原蛋白表达增强;给予Ac-SDKP干预后,HSP27、SNAI1、SNAI2及Ⅰ型、Ⅲ型胶原蛋白表达明显降低,差异有统计学意义。用HSP27的干扰质粒转扰细胞后,SNAI1、SNAI2及Ⅰ型、Ⅲ型胶原蛋白表达降低,其中SNAI1和Ⅰ型、Ⅲ型胶原蛋白的表达与TGF-β1刺激组比较差异有统计学意义。这与Ac-SDKP干预的结果相似。结论:Ac-SDKP能够通过对HSP27表达的调节,降低锌指蛋白SNAI1和SNAI2的表达,进而抑制肺泡Ⅱ型上皮细胞向肌成纤维细胞的转化及胶原蛋白的合成。